Title |
Results From a European Multicenter Randomized Trial of Physical Activity and/or Healthy Eating to Reduce the Risk of Gestational Diabetes Mellitus: The DALI Lifestyle Pilot
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Published in |
Diabetes Care, June 2015
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DOI | 10.2337/dc15-0360 |
Pubmed ID | |
Authors |
David Simmons, Judith G.M. Jelsma, Sander Galjaard, Roland Devlieger, Andre van Assche, Goele Jans, Rosa Corcoy, Juan M. Adelantado, Fidelma Dunne, Gernot Desoye, Jürgen Harreiter, Alexandra Kautzky-Willer, Peter Damm, Elisabeth R. Mathiesen, Dorte M. Jensen, Lise Lotte Andersen, Annunziata Lapolla, Maria Dalfra, Alessandra Bertolotto, Ewa Wender-Ozegowska, Agnieszka Zawiejska, David Hill, Pablo Rebollo, Frank J. Snoek, Mireille N.M. van Poppel |
Abstract |
Ways to prevent gestational diabetes mellitus (GDM) remain unproven. We compared the impact of three lifestyle interventions (healthy eating [HE], physical activity [PA], and both HE and PA [HE+PA]) on GDM risk in a pilot multicenter randomized trial. Pregnant women at risk for GDM (BMI ≥29 kg/m(2)) from nine European countries were invited to undertake a 75-g oral glucose tolerance test before 20 weeks gestation. Those without GDM were randomized to HE, PA, or HE+PA. Women received five face-to-face and four optional telephone coaching sessions, based on the principles of motivational interviewing. A gestational weight gain (GWG) <5 kg was targeted. Coaches received standardized training and an intervention toolkit. Primary outcome measures were GWG, fasting glucose, and insulin sensitivity (HOMA) at 35-37 weeks. Among the 150 trial participants, 32% developed GDM by 35-37 weeks and 20% achieved GWG <5 kg. HE women had less GWG (-2.6 kg [95% CI -4.9, -0.2]; P = 0.03) and lower fasting glucose (-0.3 mmol/L [-0.4, -0.1]; P = 0.01) than those in the PA group at 24-28 weeks. HOMA was comparable. No significant differences between HE+PA and the other groups were observed. An antenatal HE intervention is associated with less GWG and lower fasting glucose compared with PA alone. These findings require a larger trial for confirmation but support the use of early HE interventions in obese pregnant women. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 5 | 23% |
United Kingdom | 4 | 18% |
France | 2 | 9% |
Canada | 1 | 5% |
Spain | 1 | 5% |
Ireland | 1 | 5% |
Venezuela, Bolivarian Republic of | 1 | 5% |
Unknown | 7 | 32% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 12 | 55% |
Practitioners (doctors, other healthcare professionals) | 7 | 32% |
Scientists | 2 | 9% |
Science communicators (journalists, bloggers, editors) | 1 | 5% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Suriname | 1 | <1% |
Unknown | 267 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 44 | 16% |
Student > Bachelor | 42 | 16% |
Student > Ph. D. Student | 34 | 13% |
Researcher | 11 | 4% |
Student > Postgraduate | 11 | 4% |
Other | 43 | 16% |
Unknown | 83 | 31% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 74 | 28% |
Nursing and Health Professions | 45 | 17% |
Social Sciences | 11 | 4% |
Sports and Recreations | 11 | 4% |
Agricultural and Biological Sciences | 10 | 4% |
Other | 30 | 11% |
Unknown | 87 | 32% |